my step father has dementia and needs assistance. he has a relative who lives with him full time but caring for him is a challenge. He has an aide 2x a week for 4 hours from the VA hospital. can he still apply for Medicaid and receive additional aide services through them as well?
The VA looks at monthly income. If unreimbursed medical expenses are equal to your household income, you are entitled to the maximum Aid & Attendance benefit. If considered a medical expense, the family member could be paid for the value of some of the hours they devote to your step father.
The VA also looks at the value of "liquid assets" like cash, stocks, IRA, 401k, other tax-deferred income, bonds, mutual funds, art, coins, stamps, and collectibles. The Aid and Attendance pension regulations consider whether some or all of the claimant’s estate should be used for the claimant’s care. The VA considers:
whether the property can be readily converted into cash at no substantial sacrifice and life expectancy.
Get help with the application preparation from your town's veteran agent or a service provider that specializes in aid and attendance. Talking with an elder law attorney near your home would also be beneficial.
I have a client who receives twice a day care for two hours each.
If there is someone else who can do the caregiving often the responsibility will fall on them. If that person is unable to continue the caregiving schedule, VA should Step up care.
There is a Housebound Program which is easier to get than the Aide and Attendance. That may be what he already has. Just negotiate the house up.
Good Luck